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Razvoj akupunkture v Avstraliji: 2. del



Poučevanje akupunkture v Avstraliji


V Avstraliji so bili prvi zasebni kolidži za akupunkturo najprej vzpostavljeni v Sydneyu, Brisbanu in Melbournu v 1970-ih [9]. Univerza za tehnologijo v Viktoriji in univerza Royal Melbourne Institute of Technology (RMIT University) sta bili med prvimi, ki so ponudili dodiplomske programe o kitajski in zeliščni medicini. V Avstraliji ponuja programe kitajske medicine, ki med drugim lahko vključujejo tudi akupunkturo, na številnih stopnjah dvajset univerz in kolidžev.


Nekateri akupunkturni programi so bili uradno priznani s strani Chinese Medicine Registration Board of Victoria (CMRB) ali prepoznani s strani AACMA. Poleg tega univerze RMIT University, University of Technology Sydney in University of Western Sydney prav tako ponujajo raziskovalne programe na podiplomskem študiju za nadgradnjo in napredek akupunkture.


Zvezna država Viktorija je izdala Smernice glede uradnega priznavanja študijskih programov kitajske medicine kot kvalifikacija za registracijo [10]. V nedavnem so izvedli primerjalno študijo kakovosti predmetnika in poučevanja na univerzah RMIT University in Univerzi kitajske medicine v Pekingu [11]. Medtem ko so bili predmetnik in učni cilji obeh programov podobni, so obstajale tudi razlike na področjih, kot sta poučevanje o klasičnih besedilih kitajske medicine in klinično usposabljanje v bolnišnicah kitajske medicine.L. 2005 je bila izvedena raziskava na 228 registriranih izvajalcih kitajske medicine v Viktoriji [12]. Rezultati so pokazali, da so tehnične sposobnosti (predvsem akupunkture) smatrane v klinični praksi kot najpomembnejše, medtem ko raziskovanje najmanj pomembno.


Predpisi o akupunkturi v Avstraliji


Avstralska vlada je izdala Standarde prakse akupunkture - Predpisi o zdravju (nalezljive bolezni) 1990 [13]. L. 2000 je zvezna država Viktorija vpeljala Registracijski akt kitajske medicine [4] z namenom registracije izvajalcev kitajske medicine. Ta akt je bil kasneje nadomeščen z Registracijskim aktom zdravstvenih profesij 2005 [5]. Aprila 2009 je CMRB registriral 987 akupunkturistov, ki so izpolnjevali zahteve Akta [14].


Zdravstveno zavarovanje pokrije stroške akupunkture


Dandanes avstralska nacionalno zdravstveno zavarovanje (tj. Medicare) krije samo stroške akupunkture, ki jo izvajajo registrirani izvajalci. Med letoma 2005 in 2006 je bilo ocenjeno število zdravniških obiskov terapij akupunkture, ki jih je kril Medicare, 607 349 [15], kar predstavlja manj kot 10% vseh obiskov akupunkture na leto [7].

Od 1990-ih večina avstralskih zasebnih zdravstvenih zavarovalnic, kot so Medibank Private in Medical Benefits Fund for Australia, krije stroške akupunkture. Raziskava glede učinkovitosti in varnosti akupunktureThe RMIT Chinese Medicine Research Group (RCMRG) je izvedla randomizirane nadzorovane raziskave (RCT) o akupunkturi kot obliki zdravljenja za alergijski rinitis, glavobol, migrene in kronične bolečine. Raziskovalci v Avstraliji so prav tako znatno prispevali k Cochrane podatkovni bazi sistematičnih ocen skozi raziskovanje o akupunkturi kot obliki zdravljenja za depresijo [22], sprožitev poroda [23], bolečine komolca [24], bolečine v ramenu [25] in fibromialgije [26].


Laserska akupunktura je alternativa tradicionalni akupunkturi. Odkritja RCT, ki so vključevala 30 preiskovancev z blago do zmerno depresijo, so pokazala, da je imela skupina s pravo akupunkturo znatno boljše rezultate kot skupina z akupunkturo z neaktivnim laserjem [27]. Večina izvedenih kliničnih raziskav o akupunkturi je bilo registriranih pri Australian Therapeutic Goods Administration in the Australian New Zealand Clinical Trial Registry. Sledeč uvedbi Konsolidiranih standardov o poročanju o raziskavah (CONSORT Statement) l. 1996 [28] so bile avstralske klinične raziskave podane v obliki poročil, ki so ustrezala temu mednarodnemu standardu. Izzivi v kliničnih raziskavah akupunkture ostajajo, še posebej pri učinkovitosti oblike in kontrolni skupini, ki prejme lažno akupunkturo [30]. Raziskovalci so našli nekaj strategij za vzdrževanje kredibilnosti lažne akupunkture kot obliko kontrolne skupine v kliničnih raziskavah [31].


Nasproti ozadju porasta števila raziskav na področju kitajske medicine v Avstraliji je začela l. 2006 izhajati revija Australian Journal of Acupuncture and Chinese Medicine, ki je bila prva strokovno ocenjena in pregledana revija kitajske medicine v Avstraliji.


Povzetek


Nedavni razvoj akupunkture v Avstraliji indicira, da je akupunktura skozi zadostno in primerno evaluacijo v procesu vključevanja v običajno zdravstveno oskrbo v Avstraliji.


Izvirni članek in vire lahko najdete na naslednji povezavi: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684102/


prevod: Tanja Topić

vir fotografij: internet

Developments of acupuncture in Australia- Part 2


Acupuncture education in Australia


In Australia, private acupuncture colleges were first established in Sydney, Brisbane and Melbourne in the 1970s [9]. The Victoria University of Technology and the Royal Melbourne Institute of Technology (RMIT University) were among the first to offer degree courses in acupuncture and Chinese herbal medicine. Twenty universities and colleges in Australia offer Chinese medicine courses at various levels which may also include acupuncture. Some of the acupuncture programs have been approved by the Chinese Medicine Registration Board of Victoria (CMRB) or recognised by the AACMA.

Moreover, the RMIT University, University of Technology Sydney and University of Western Sydney also offer research programs for acupuncture stream at postgraduate level. The State of Victoria has issued the Guidelines for the Approval of Courses of Study in Chinese Medicine as a Qualification for Registration [10]. A comparative study on the curricula and teaching quality between the RMIT University and Beijing University of Chinese Medicine was recently conducted [11]. While the curricula and educational objectives of the two programs were similar, differences existed in areas such as teaching classical Chinese medicine texts and clinical training in Chinese medicine hospitals. A survey on 228 registered Chinese medicine practitioners in Victoria was conducted in 2005 [12]. Its results showed that technical capabilities (acupuncture in particular) were considered as the most important in clinical practice, whereas research was considered the least important.


Acupuncture regulation in Australia


The Australian Government issued the Standards of Practice for Acupuncture – Health (Infectious Diseases) Regulations 1990 [13]. In 2000, the State of Victoria implemented the Chinese Medicine Registration Act [4] for the purpose of registration of Chinese medicine practitioners. This Act was subsequently replaced by the Health Professions Registration Act 2005 [5]. By April 2009, the CMRB has registered 987 acupuncturists who met the requirements of the Act [14].


Health insurance rebates for acupuncture


At present, Australian national health insurance (i.e. Medicare) only covers the cost of acupuncture provided by registered medical practitioners. Between 2005 and 2006, the number of medical acupuncture visits rebated by Medicare was estimated to be 607,349 [15], representing less than 10% of the total estimated acupuncture visits per year [7]. Since the 1990s, most of the private health insurance companies in Australia, such as Medibank Private and Medical Benefits Fund of Australia, have been providing rebates for acupuncture.Research on acupuncture efficacy and safetyThe RMIT Chinese Medicine Research Group (RCMRG) conducted randomised controlled trials (RCTs) on acupuncture as a treatment for allergic rhinitis, headache, migraine and chronic pain. Researchers in Australia have also made considerable contributions to the Cochrane Database of Systematic Reviews in the investigation on acupuncture to treat depression [22], induction of labour [23], lateral elbow pain [24], shoulder pain [25] and fibromyalgia [26].


Laser acupuncture is an alternative method to traditional acupuncture. Findings from an RCT involving 30 subjects with mild to moderate depression showed that the laser acupuncture group had significantly lower depression scores than did the inactive laser acupuncture group [27].Most acupuncture clinical trials conducted in Australia are registered with the Australian Therapeutic Goods Administration and the Australian New Zealand Clinical Trial Registry. Following the introduction of the Consolidated Standards of Reporting Trials (CONSORT Statement) in 1996 [28] and its revised version in 2001 [29], clinical trials in Australia have been reported in accordance with this international standard.Challenges in acupuncture clinical trials remain, especially in effective design and control group such as sham [30]. Researchers have identified some strategies to maintain the credibility of sham acupuncture as a control in clinical trials [31].


Against the backdrop of increasing Chinese medicine research in Australia, the Australian Journal of Acupuncture and Chinese Medicine was launched in 2006 as the first peer-reviewed journal on Chinese medicine in Australia.


Conclusion


Recent developments of acupuncture in Australia indicate that through adequate and appropriate evaluation, acupuncture is being integrated into mainstream health care in Australia.


The original article and reference can be found in this link https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684102/

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